Zika virus infection in a pediatric patient with acute gastrointestinal involvement

Zika virus (ZIKV) is a mosquito-borne flavivirus, which has been related to severe neurological complications in neonates. However, many clinical aspects of the infection remain unclear, especially in pediatric patients. In this case report we describe the uncommon presentation of ZIKV infection in a pediatric patient with acute gastrointestinal involvement hospitalized in a Brazilian Emergency Unit. Dengue hemorrhagic fever was initially suspected, however, the molecular result for Dengue was negative. Molecular testing for other arboviruses (ZIKV and Chikungunya), revealed positive for ZIKV RNA result in both blood and saliva. The ZIKV load in saliva (6.947 copies/mL) was higher than the vetected ZIKV RNA in plasma (1.945 copies/mL). Additionally, the performed abdominal ultrasound revealed mesenteric lymphadenitis without abdominal retention of fluids. The presentation of this case demonstrates that ZIKV can be involved in a broader range of clinical conditions than currently assumed, including pediatric emergencies, especially in regions with extensive ZIKV outbreaks.